On World Cancer Day 2016: Study explains why HPV vaccination rates are low in Hawaii

In order to address concerns for the low uptake of the human papillomavirus (HPV) vaccine, the University of Hawai‘i Cancer Center in collaboration with the John A. Burns School of Medicine recently conducted a survey of 120 primary care physicians statewide. The findings of the Hawaii HPV Immunization Improvement Project, released on World Cancer Awareness Day, point to reasons why the vaccine rate has remained low in the state among boys and decreased in recent years among girls -- 38 percent and 31 percent, respectively compared to the national goal of 80 percent.

What the UH Cancer Center/JABSOM HPV study found

Many physicians (83%) felt that parent knowledge and understanding of HPV infection and lack of belief that their child was at risk for HPV infection were major barriers to vaccination.

Physicians cited ordering, stocking costs, reimbursement levels and insurance coverage as impediments to vaccination. These cost-related issues were significantly more burdensome to physicians in private practice.

Over half of physicians (58%) reported that lack of follow-up up was a barrier to the completion of the 3-dose schedule, yet most did not use specific tracking or reminder systems to ensure dose completion.

Fifty-eight percent of providers cited the lack of school-based vaccination requirements as a barrier to HPV vaccination.

“HPV-related cancers are preventable. We aim to have Hawai‘i reach the national goal of having 80 percent of our children vaccinated. The findings allow us to create more tailored educational and counseling resources for physicians and patients to help increase the HPV vaccination rate,” said Lee Buenconsejo-Lum, MD, JABSOM associate professor and associate member of the UH Cancer Center.

Prevention is key to lowering incidence rates of HPV-related cancers

Approximately 79 million people in the United States are currently infected with HPV, according to the Centers for Disease Control and Prevention (CDC), and 14 million new infections occur each year. Several types of high-risk HPV are responsible for the vast majority of cervical, anal, oropharyngeal (middle throat) and other genital cancers.

Many of these HPV-related cancers are preventable with a safe and effective vaccine. However, despite the availability, safety and efficacy of the HPV vaccine, vaccination rates across the U.S. remain low. Only 40% of girls and 21% of boys in the U.S. are receiving the recommended three doses of the HPV vaccine.

The low rate of HPV vaccination is a serious public health threat

The UH Cancer Center along with 68 other National Cancer Institute (NCI)-designated Cancer Centers recently issued a joint statement, with the following recommendations:

• We encourage all parents and guardians to have their sons and daughters complete the 3-dose HPV vaccine series before their 13th birthday, and complete the series as soon as possible in children aged 13 to 17. Parents and guardians should talk to their health-care provider to learn more about the benefits of HPV vaccination.

• We encourage young men (up to age 21) and young women (up to age 26), who were not vaccinated as preteens or teens, to complete the 3-dose HPV vaccine series to protect themselves against HPV.

• We encourage all health-care providers to be advocates for cancer prevention by making strong recommendations for childhood HPV vaccination. We ask providers to join forces to educate parents/guardians and colleagues about the importance and benefits of HPV vaccination

The University of Hawai‘i Cancer Center is one of 69 research institutions designated by the National Cancer Institute. Affiliated with the University of Hawai‘i at Manoa, the center is dedicated to eliminating cancer through research, education, and improved patient care. Learn more at www.uhcancercenter.org. Like us on Facebook at www.facebook.com/UHCancerCenter. Follow us on Twitter @UHCancerCenter.

The John A. Burns School of Medicine (JABSOM) at the University of Hawaiʻi honors its unique research environment to excel in science-based efforts to eliminate diseases that disproportionately affect people in Hawaiʻi and the Pacific region. U.S. News & World Report ranked JABSOM among the top 20 medical schools in the country for Primary Care in 2016​. Annually at JABSOM, more than 600 students or trainees are learning medicine, practicing medicine under our supervision or seeking biomedical science degrees.